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In Medical Informatics three types of processes play a central role: organizational, patient-related and decision making-related processes. The first type deals with settings, such as a hospital care setting or a primary care setting; the second is related to health and disease (i.e. to patients); the third type of process aims at assisting in decision making and therapy and evolves in the brains of healthcare professionals. Hence, in all domains data, information and knowledge play a key role. As these tree processes evolve, dealing with individuals - patients, doctors and nurses - because of that human factor there are obviously limitations imposed by formalization and standardization. In the past, there have been some unrealistic expectations regardingthe possible contributions of medical informatics to healthcare. However, such contributions appeared to be very modest, to say the least. The same applies to the overly optimistic expectations regarding the introduction of electronic health records. Althugh the technology is widely available, all these developments appear to be far more complex than expected. The need for an improved understanding of the nature of medical knowledge to better serve health remains to be emphasized.

Regularly reviewing the'state-of-the-art'developments in the antiviral drug research field, this latest volume spans the conceptual design and chemical synthesis of new antiviral compounds. It discusses their structure-activity relationship, mechanism and targets of action, pharmacological behavior, antiviral activity spectrum, and therapeutic potential for clinical use.

'Information technology helps to improve the quality of health care by disseminating and systematizing knowledge of diagnostic and therapeutic possibilities as well as the organization and management of care. Unobtrusive, active, non-invasive technologies, including wearable devices, allow us to continuously monitor and respond to changes in the health of a patient. Such devices range from micro-sensors integrated in textiles, through consumer electronics, to belt-worn personal computers with head mounted displays. Such ubiquitous computing allows us to identify new ways of managing care that promises to be considerably easier in letting patients maintain their good health while enjoying their life in their usual social setting, rather than having to spend much time at costly, dedicated health care facilities. It may prove essential for ensuring quality of life as well as health care for increasingly aging societies. In addition to the traditional topics of health and biomedical informatics,'Ubiquity: technologies for better health in aging societies', a promising field for the future of health care, has been chosen as special topic for this publication of MIE2006'--Publisher's description

The fourth volume of Advances in Antiviral Drug Design is keeping up with the recent progress made in the broad field of antiviral drug research and encompasses six specific directions that have opened new avenues for the treatment of HIV and other virus infections.First, as the introductory chapter, the different new anti-HIV agents that are now in preclinical or clinical development are reviewed by E. De Clercq. This includes new NRTIs, NNRTIs and PIs, but also HIV entry/fusion inhibitors as well as integrase inhibitors, and some of these agents, such as the NRTI emtricitabine [(-)FTC] and the PI atazanavir, may soon be licensed for clinical use.Second, high expectations are vested in the potential therapeutic usefulness of inhibitors of HIV integration, a point of no return in the life cycle of HIV, and this approach is highlighted by D.J. Hazuda and S.D. Young.Third, as all currently available PIs can be described as'peptidomimetic', and, therefore, expected to demonstrate overlapping virus-drug resistance and side effect profiles, it would be interesting to see how a non-peptidic protease inhibitor such as tipranavir behaves, and this is covered by D. Mayers, K. Curry, V. Kohlbrenner and S. McCallister.Fourth, neuraminidase inhibitors such as zanamivir (that has to be inhaled) and oseltamivir (that can be administered via the oral route) have gained a definitive status as antiviral drugs useful for both therapy and prophylaxis of influenza A and B virus infections; as they target a specific influenza viral enzyme, neuraminidase (or sialidase), they may be expected to block newly emerging influenza viruses as well, and the design of neuraminidase inhibitors has received due attention of H. Jin and C.U. Kim.Fifth, while the major current efforts in antiviral drug development have shifted from herpesviruses towards HIV and hepatitis viruses [hepatitis B virus (HBV), hepatitis C virus (HCV)], it is interesting to note that by switching from the classical five-membered sugar or acyclic nucleoside strategy, J. Wang, M. Froeyen and P. Herdewijn have gone'upstream'in designing six-membered carbocyclic nucleosides as potential anti-herpesvirus agents.Sixth, following up on the nucleotide prodrug strategy introduced above under ix, to deliver the biologically active nucleotides inside the cells, C. Meier has elaborated on a particular class of such pronucleotides, namely that of the cyclosaligenyl pronucleotides, an approach that should have far reaching implications for compounds effective against HIV, HBV and other viruses.The six topics covered in this fourth volume of Advances in Antiviral Drug Design are in the front line of the present endeavors towards the design and development of new therapeutic agents for virus infections. They pertain to the combat against three of the most important viral pathogens of current times: HIV, HBV, influenza virus and herpesviruses.

The MIC (Medische Informatica Congres, Medical Informatics Congress) has a long tradition in Belgium and in the Netherlands. It started in 1978 in Rotterdam, continued in 1979 in Antwerp, and its 20th editionwas held in Brussels (5-7 December 2002). MIC 2002 is organised in association with the Healthcare Telematics in Belgium symposium of the Belgian Federal Ministry of Social Affairs and Public Health. These two Conferences share new trends in health informatics, such as local standards for patient records and for hospital information systems, messages exchanges and privacy protection, as well as on line health networks. This book deals also with more academic subjects like clinical research and e-learning, as well as with specific applications in relation to nursing, pharmacy and general practice. This collection of papers presents many timely new ideas and practical proposals. The MIC 2002 proceedings will help to develop further collaboration in the field of health informatics in these two countries and in Europe.

Volume 3 of Advances in Antiviral Drug Design is keeping up with the recent progress made in the field of antiviral drug research and highlights five specific directions that have opened new avenues for the treatment of virus infections. First, the use of lamivudine (3TC) for the treatment of HIV infections, and its more recent introduction for the treatment of hepatitis B virus (HBV) infections, has heralded the transition of D- to L-nucleosides in the antiviral nucleoside drug design, and it is likely that the future will provide more nucleosides of the L-configuration, such as (-)FFC (emtricitabine) and L-FMAU, as will be described by J.-C.G. Graciet and R.F. Shinazi. Second, the acyclic purine nucleoside phosphonates, i.e. PMEA (adefovir and PMPA (tenofovir), offer great potential as both anti-HIV and anti-HBV agents, and both compounds have been the subject of advanced clinical trials in their oral produrg form (adefovir dipivoxil and tenofovir disoproxyl), as mentioned by M.N. Arimilli, J.P. Dougherty, K.C. Cundy, and N. Bischofberger.Third, with the advent of nevirapine, delavirdine, and efavirenz, the NNRTIs have definitely come of age. Emivirine (MKC-442), a derivative of the original HEPT analog that was described in 1989 has now proceeded through pivotal clinical studies, and how this class of compounds evolved is presented in the account of H. Tanaka and his colleagues. Fourth, at the end of 1999, anticipating on the next winter influenza offensive, we should have at end two compounds that specifically inhibit influenza A and B virus infections: zanamivir (by the intranasal route) and oseltamivir (by the oral route). Both compounds have proved effective in the prophylaxis and treatment of influenza A and B virus infections and act through the same mechanism; that is by blocking the viral neuraminidase (or sialidase), a key enzyme that allows the virus to spread from one cell to another (within the respiratory mucosal tract). The design of these sialidase inhibitors will be presented by M. von Itzstein and J.C. Dyason.Fifth, the discovery (in 1996) of the chemokine receptors CXCR4 and CCR5 as essential coreceptors (in addition to the CD4 receptor) for HIV entry into the cells, has boosted an enormous interest in potential antagonists of these receptors. The bicyclams represent the first low-molecular-weight compounds targeted at CXCR4, the coreceptor used by the more pathogenic, T-lymphotropic, HIV strains, to enter the cells. They will be addressed by G.J. Bridger and R.T. Skerlj.The five topics covered in this third volume of Advances in Antiviral Drug Design are in the front line of the present endeavors towards the chemotherapy of virus infections. They pertain to the combat against three of the most important virus infections of current times: HIV, HBV, and influenza virus.

The purpose of the series on Advances in Antiviral Drug Design is to regularly review the'state of the art'on emerging new developments in the antiviral drug research field, thereby spanning the conceptual design and chemical synthesis of new antiviral compounds, their structure-activity relationship, mechanism and target(s) of action, pharmacological behavior, antiviral activity spectrum, and therapeutic potential for clinical use. Volume 2 begins with a description of the antiviral potential of antisense oligonucleotides by J. Temsamani and S. Agrawal. According to the aims of the anitsense technology, these oligonucleotides should be targeted at specific viral antisense technology, these oligonucleotides should be targeted at specific viral mRNA sequences so that translation to the virus-specified proteins is blocked; this has been achieved for a number of oligomers, some of which are now in clinical trials for the treatment of HIV, HCMV, and human papilloma virus (HPV) infections. Then C.-S. Yuan, S. Liu, S.F. Wnuk, M.J. Robins and R.T. Borchardt assess the role of S-adenosylhornocysteine (AdoHcy) hydrolase as target for the design of antiviral agents with broad-spectrum antiviral activity. This is followed by an in-depth account on the design and synthesis of a number of first-, second- and third-generation AdoHcy hydrolase inhibitors and their mode of action at the enzyme level.V.E. Marquez provides a comprehensive description of the various carbocyclic (carba) nucleosides that have been synthesized and evaluated for antiviral activity. Although the number and diversity of the carba-nucleosides that have been found to be antivirally active (or inactive) is astonishingly high, there is no limit to further expansion of this fascinating class of molecules. For the various nucleoside analogues that have to be intracellularly phosphorylated to the 5'-triphosphate stage, to interact with their target enzyme (i.e., herpesviral DNA polymerase or retroviral revers transcriptase) the first phosphorylation step is often the rate-limiting step, and thus various strategies are envisaged by C. Perigoud, J.-L. Girardet, G. Gosselin and J.-L. Bach on how to bypass this initial phosphorylation and to deliver the nucleoside 5'-monophophate directly inside the cells.The HIV protease has been considered as a paradigm for rational drug design. The enzyme is among the best understood in terms of both structure and action, and because of its crucial role in the maturation of HIV, it has been vigorously pursued as a target for anti-HIV chemotherapy. In their comprehensive review of the multidisciplinary approach towards the development of HIV protease inhibitors A.G. Tomasselli, S. Thaisrivongs and R.L. Heinrikson highlight those protease inhibitors which have been brought forward to clinical trials.